Analysis of Genetic Variants MTHFR C677T, ACE I/D, AT1R A1166C and eNOS 4a/b in the Context of Essential Hypertension

Remus Nica1,2, Silvia Nica3,4, Luciana Teodora Rotaru5

  • 1Faculty of Midwifery and Nursing, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Biomedicines
|November 27, 2025
PubMed

Insights

Essential hypertension (EH) risk is linked to ACE I/D and MTHFR C677T gene variants in Romanians. Smoking amplifies this risk, highlighting gene-environment interactions in hypertension development.

Area of Science:

  • Genetics and Cardiovascular Disease Epidemiology

Background:

  • Arterial hypertension (AH) is a major risk factor for cardiovascular diseases, the leading cause of global mortality.
  • Essential hypertension (EH), lacking a specific cause, accounts for most AH cases worldwide.

Purpose of the Study:

  • To investigate the association between EH and genetic variants MTHFR C677T, ACE I/D, AT1R A1166C, and eNOS 4a/b in the Romanian adult Caucasian population.
  • To explore potential interactions between these genetic factors and lifestyle choices.

Main Methods:

  • A case-control study involving 845 EH patients and 845 controls from Romania.
  • Genotyping of MTHFR C677T, ACE I/D, AT1R A1166C, and eNOS 4a/b polymorphisms using PCR-based methods.
  • Collection of clinical, para-clinical, and lifestyle data.

Main Results:

  • ACE DD and MTHFR TT genotypes were associated with an increased risk of EH (OR=1.44, p=0.0007 and OR=1.46, p=0.0007, respectively).
  • Smoking and physical activity were identified as associated lifestyle factors.
  • Combined ACE DD or MTHFR TT genotypes with smoking significantly increased EH risk (e.g., ACE DD + smoking: OR=1.62, p=0.0005).

Conclusions:

  • The ACE I/D and MTHFR C677T polymorphisms appear to contribute to EH susceptibility.
  • AT1R A1166C and eNOS 4a/b polymorphisms showed no significant association with EH in this population.
  • Gene-environment interactions, particularly between ACE/MTHFR variants and smoking, heighten the risk of developing essential hypertension.

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